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> I've told this story here before. My girlfriend at the time, now wife and I both had pneumonia. Identical symptoms. > We saw the same doctor the same day, ba

> I've told this story here before. My girlfriend at the time, now wife and I both had pneumonia. Identical symptoms. > We saw the same doctor the same day, back to back. Got prescribed the same antibiotics. > I had "good" health insurance, she had none. My bill AFTER insurance was higher than her bill without insurance. > I'm really not sure the moral but it was frustrating as heck. The moral is that any system which introduces price opacity will gradually increase the price of the product until the price is above what the market will bear. Look at it this way - at the point of purchase, you are buying a product with absolutely no price information, because "the insurance will take care of it". With no price information to the consumer, there is no price discovery, and without price discovery the supplier will increase prices beyond what the consumer is willing to pay. If all medical insurances were banned, the cost of medical will not exceed what the market will bear: it can't. But that's extreme - how about a practical and workable solution: no private dealings between medical insurance suppliers and medical service suppliers. You have medical insurance? Lovely - you will be forced to submit the claim yourself. When you visit the medical services supplier (doc, hospital, pharmacy, etc) for non-emergency services[1], you will be liable for the bill, and so you will have to lookup what that/those particular code/codes cost/s. In this way the cost of medical services will actually come down, to what the market will bear. We've seen the same thing with US tertiary education - free money introduced into the system by the government caused tuition fees to skyrocket, with all the profit captured by the providers. IOW, the price rose to what the market will bear, and since the government was the market in this case, the price rose to what the government was able to pay, which is perhaps 3x to 10x what an unemployed 18 yo is able to pay. [1] For emergency care, obviously the claim will be submitted to you by the hospital, and you can then forward that claim to the insurance. Even better would be if all emergency procedures have state-backed insurance.

troupo 3y ago
> You have medical insurance? Lovely - you will be forced to submit the claim yourself. When you visit the medical services supplier (doc, hospital, pharmacy, etc) for non-emergency services[1], you will be liable for the bill, and so you will have to lookup what that/those particular code/codes cost/s. Ah yes. Because I, the lay person, know exactly what all those codes mean and their actual costs. > IOW, the price rose to what the market will bear, and since the government was the market in this case, the price rose to what the government was able to pay, which is perhaps 3x to 10x what an unemployed 18 yo is able to pay. Strange how this didn't play out in (most of) Europe.
- lelanthran 3y ago
  > Ah yes. Because I, the lay person, know exactly what all those codes mean and their actual costs. Why would you need to know? Serious question - how does it help to know what all those codes mean and their actual costs? All you need to know is $INSURANCEPROVIDER only covers $100 of a bill for $CODE. What do you care what the "actual cost" of $CODE is for $MEDICALPROVIDER? > Strange how this didn't play out in (most of) Europe. Because what the government was able to pay was a lot less than what the US government was able to pay, because the US government provided the money (with basically no controls on cost) and then made the student liable for paying it back. This way the state didn't actually care what the purchase price was, they were always going to get it back anyway. My understanding is that in Europe (e.g. Germany), the tuition was paid for by the state! It's not a loan, the state is not getting that money back, and so there's pressure on the state to limit what it will pay for tuition.
  - troupo 3y ago
    > Why would you need to know? Who is "you" then in this quote: "You have medical insurance? Lovely - you will be forced to submit the claim yourself. When you visit the medical services supplier (doc, hospital, pharmacy, etc) for non-emergency services[1], you will be liable for the bill, and so you will have to lookup what that/those particular code/codes cost/s."
    - lelanthran 3y ago
      My point is that you don't need to > know exactly what all those codes mean and their actual costs. Why would you need to know? How does it help knowing the actual cost vs what your out-of-pocket expenses? You get $FOO as the code and $BAR as the cost. That lets the market discover, over time, which providers are charging $BAR+$EXTRA, which insurances only cover $BAR-$uncovered. You can't have price discovery if the purchaser is not able to determine what the price is at the point of payment. If you have a better proposal for determining what the market will bear, lets hear it. I'm not sure where you're going with this line of questions, but the impression I get from your comments are "People will find it too confusing to know how much they are are purchasing something for - let them only discover the price of the purchase after they have already bought it". TBH, it's never a good idea to reveal the purchase price of something only after the purchase is made. There is no justification for it.
stemlord 3y ago
No need to quote the entire parent message

troupo 3y ago

> You have medical insurance? Lovely - you will be forced to submit the claim yourself. When you visit the medical services supplier (doc, hospital, pharmacy, etc) for non-emergency services[1], you will be liable for the bill, and so you will have to lookup what that/those particular code/codes cost/s. Ah yes. Because I, the lay person, know exactly what all those codes mean and their actual costs. > IOW, the price rose to what the market will bear, and since the government was the market in this case, the price rose to what the government was able to pay, which is perhaps 3x to 10x what an unemployed 18 yo is able to pay. Strange how this didn't play out in (most of) Europe.

lelanthran 3y ago
> Ah yes. Because I, the lay person, know exactly what all those codes mean and their actual costs. Why would you need to know? Serious question - how does it help to know what all those codes mean and their actual costs? All you need to know is $INSURANCEPROVIDER only covers $100 of a bill for $CODE. What do you care what the "actual cost" of $CODE is for $MEDICALPROVIDER? > Strange how this didn't play out in (most of) Europe. Because what the government was able to pay was a lot less than what the US government was able to pay, because the US government provided the money (with basically no controls on cost) and then made the student liable for paying it back. This way the state didn't actually care what the purchase price was, they were always going to get it back anyway. My understanding is that in Europe (e.g. Germany), the tuition was paid for by the state! It's not a loan, the state is not getting that money back, and so there's pressure on the state to limit what it will pay for tuition.
- troupo 3y ago
  > Why would you need to know? Who is "you" then in this quote: "You have medical insurance? Lovely - you will be forced to submit the claim yourself. When you visit the medical services supplier (doc, hospital, pharmacy, etc) for non-emergency services[1], you will be liable for the bill, and so you will have to lookup what that/those particular code/codes cost/s."
  - lelanthran 3y ago
    My point is that you don't need to > know exactly what all those codes mean and their actual costs. Why would you need to know? How does it help knowing the actual cost vs what your out-of-pocket expenses? You get $FOO as the code and $BAR as the cost. That lets the market discover, over time, which providers are charging $BAR+$EXTRA, which insurances only cover $BAR-$uncovered. You can't have price discovery if the purchaser is not able to determine what the price is at the point of payment. If you have a better proposal for determining what the market will bear, lets hear it. I'm not sure where you're going with this line of questions, but the impression I get from your comments are "People will find it too confusing to know how much they are are purchasing something for - let them only discover the price of the purchase after they have already bought it". TBH, it's never a good idea to reveal the purchase price of something only after the purchase is made. There is no justification for it.

stemlord 3y ago

No need to quote the entire parent message